A longitudinal study, authored by Leonard A. Jason, Margaret I. Davis and Joseph R. Ferrari of DePaul University, researched the variables that affect long-term addiction recovery. The study was funded via a grant from the National Institute on Drug Abuse (NIDA) and was conducted in 2006.
The authors of the one-year study sought to explore the connection between social support and self-efficacy over time, and subsequent relapse rates. In addition to chronicling abstinence among the participants, the authors also assessed the extent to which they maintained employment and refrained from criminal activity.
The authors hypothesized that cumulative abstinence from alcohol use and abstinence self-efficacy would be predicted by support levels and length of stay in a sober residency. The study sought to determine whether substance use support played a direct role in abstinence or whether its influence was mediated by abstinence self-efficacy, after a stay of six months or more in the sober residency.
The study sample
A national sample of Oxford House residents were invited to participate voluntarily in the one-year longitudinal study, with a total of 897 agreeing (604 men and 293 women). The Oxford House program was established in 1975 and, at the time of the study, had 1,200 houses across the U.S. and 30 houses in Canada. The program combines 12-step support within a network of recovery homes for substance abuse. The mutual-help model emphasizes developing long-term sobriety skills in a setting with recovering peers. The homes are financially self-supported and there are no professionals involved, similar to Alcoholics Anonymous.
Average age of the sample participants was 38.4 years; the sample was ethnically diverse, with 58.4 percent Caucasian, 34 percent African-American, 3.5 percent Hispanic and 4 percent other; 69 percent were employed full-time, 13.9 percent part-time, 11.6 percent unemployed and 3.8 percent retired or disabled; 49 percent were single or never married, 46.2 percent were divorced, widowed or separated and only 4.8 percent were married.
The study administered various test instruments at specified segments of the one-year study. The authors used the entire scale of the Addiction Severity Index (ASI) at the outset of the study, and a portion of it at the end of the period. The ASI measures substance abuse history, physical and mental health information, and criminal activity, as well as providing socio-demographic data.
At baseline and at each segment point, participants were administered a modified version of the Form 90 Timeline Follow-back (Miller and Del Boca, 1994), which measures general health care utilization and residential history, and past 90-day alcohol and drug use.
Also, at baseline and at each follow-up point, study participants completed a modified version of Important People and Activities Inventory (Clifford and Longbaugh, 1991), which provided details regarding the composition and utilization of participants’ support networks.
Participants were administered the Alcohol Abstinence Self-Efficacy scale (DiClemente, Carbonari, Montgomery and Hughes, 1994) to measure how they would respond in certain high-risk situations for relapse.
The authors found that 81 percent of the study participants who had left the Oxford House after six or more months of residency remained consistently alcohol- and drug-free. In addition, 80 percent were employed by the final study assessment, demonstrating the positive effect of peers encouraging and helping fellow residents to find work. Also, the percentage of incarceration remained at low levels throughout the study.
The Oxford House settings likely promote abstinence supporting systems and provide a communal-style living environment that fosters bonding and sharing common abstinence goals. Self-efficacy facilitation appears to be related to successful abstinence and coping activities fostered while in residence at Oxford House.
Another cumulative abstinence factor is time spent in residence at Oxford House. Those who spent six months or more had higher cumulative abstinence (81 percent) versus the participants who left the residence early (67 percent). The overall results indicate that long-term abstinence was enhanced by receiving abstinence support and guidance from fellow residents committed to a mutual goal of long-term sobriety, in addition to 12-step program participation and stay length in the recovery setting.
Sovereign Health of California is an addiction, mental health and dual diagnosis treatment provider, offering several locations in California in addition to centers in Utah, Arizona and Florida. For more information on drug and alcohol addiction and treatment, please call (866) 629-0442.
Written by Eileen Spatz, Sovereign Health Group writer